Changes in mass and performance in rabbit muscles after muscle damage with or without transplantation of primary satellite cells

Changes in morphology, metabolism, myosin heavy chain gene expression, and functional performances in damaged rabbit muscles with or without transplantation of primary satellite cells were investigated. For this purpose, we damaged bilaterally the fast muscle tibialis anterior (TA) with either 1.5 or 2.6 ml cardiotoxin 10(-5) M injections. Primary cultures of satellite cells were autotransplanted unilaterally 5 days after muscle degeneration. Two months postoperation, the masses of damaged TAs, with or without transplantation, were significantly larger than those of the controls. Furthermore, damaged transplanted muscles weighed significantly more than damaged muscles only. The increase in muscle mass was essentially due to increased fiber size. These results were independent of the quantity of cardiotoxin injected into the muscles. Maximal forces were similar in control and 2.6 ml damaged TAs with or without satellite cell transfer. In contrast, 1.5 ml damaged TAs showed a significant decrease in maximal forces that reached the level of controls after transplantation of satellite cells. Fatigue resistance was similar in control and 1.5 ml damaged TAs independently of satellite cell transfer. Fatigue index was significantly higher in 2.6 ml damaged muscles with or without cell transplantation. These changes could be explained in part by muscle metabolism, which shifted towards oxidative activities, and by gene expression of myosin heavy chain isoforms, which presented an increase in type IIa and a decrease in type I and IIb in all damaged muscles with or without cell transfer. Under our experimental conditions, these results show that muscle damage rather than satellite cell transplantation changes muscle metabolism, myosin heavy chain isoform gene expression, and, to a lesser extent, muscle contractile properties. In contrast, muscle weight and fiber size are increased both by muscle damage and by satellite cell transfer.     

Clinical evaluation of acetate-free biofiltration at 84 0/00 in patients with chronic renal insufficiency

We report in this study the outcome of chronically hemodialysed patients with a new technique: Acetate free biofiltration 84@1000. This study is divided into two steps: during the first period we studied the hemodynamic stability of the technique in patients hemodynamically unstable under bicarbonate hemodialysis. During the second period we compared the hemodynamic effects and the quality of dialysis in these patients with other patients under bicarbonate hemodialysis. We obtained less hypotensive episodes, a better correction of acidosis, a better tolerance of the technique and comfort of the patient with the new technique, the quality of dialysis was the same with both techniques. We recommend the use of acetate free biofiltration 84@1000 whenever the patients are hemodynamicallyunstable with bicarbonate hemodialysis.     

Kaposi' s sarcoma. A series of 65 cases

Kaposi sarcoma (SK) is characterized by proliferation of vascular and spindle-shaped cells with variable clinical presentations. The association with AIDS modifies the profile of this disease. The pathophysiology seems to be based on the major role HHV-8. The goal of this work was to specify the profile of this disease in our region through a retrospective study of 65 cases of SK over a 23-year period (1981-2003). In our series, the classic form prevailed 163 cases (96.9%)]. One patient had a secondary form due to steroid therapy and another patient had a KS associated with AIDS. A male prevalence was noticed (M/F: 2.8). Cutaneous lesions were dominated by papulo-nodular lesions (90.9%) of the lower limbs (92.3% of the cases). Mucous lesions were present in 15.4% of the cases. Therapeutic abstention was decided in 38.4%. Surgical excision was indicated in 35.4% of cases, radiotherapy in 4.6% of the cases and chemotherapy in 23% of the cases. The classic form of KS is the most frequent in our area; the other forms remaining rare.     

Focus on the various techniques of anaesthesia in ophthalmologic surgery

Ophthalmologic surgery is not a vital one. It mostly concerns patients in extreme ages: children and old people. The risk of anaesthesia mainly depends on the health conditions of the patient. General anaesthesia through use of intravenous drugs alters the balance of the endocrine and sympathetic systems. Tracheal airway intubation constitutes an added constraint and stress especially for the vascular system. Retrobulbar anaesthesia is not devoid of risks: ptosis, diplopic, orbit haematoma, lesion of the optic nerve, eye perforation, vascular occlusion, intra arterial injection, neurologic and cardiovascular toxic effects of local anaesthetics, are all ever present risk Topical anaesthesia with its various variants (single topic or associated with intracameral injection, subconjunctival, circumferential perilimbal, subtenon) represents an interesting alternative for it is simple, less toxic and harless. In our experience, this method is indicated in surgery of eye's anterior segment. We find it safe, efficacisious and economical. Regional anaesthesia is preferred to general anaesthesia especially in the surgery of dacryocystitis and ptosis. General anaesthesia in stell indicated in case of children.     

Cryoglobulinemia in chronic hepatitis C virus infection. About 76 cases

Cryolobulines are immunoglobulins that persist in the serum, precipitate with cold temperature and resolubilize when rewarmed. There are 3 types of cryoglobulinemia. Type II and III define mixed cryoglobulinemia. 40% approximately of patients with chronic hepatitis C virus (HCV) infection had cryoglobulinemia. OBJECTIVE: To evaluate the frequency of cryoglobulinemia in a chronic hepatitis virus (CHV) infection group and determine the characteristics of positive cryoglobulinemia patients. RESULTS: 76 patients were included. There were 53 women an 23 men. The mean age was 59.45 years. Mixed cryoglobulinemia was detected in 65 patients (85.5 %). Cirrhosis, old age and the long duration of CHV infection were the 3 factors associated with cryoglobulinemia positivity. CONCLUSION: Mixed cryoglobulinemia is a frequent manifestation during chronic hepatitis C infection virsus especially in patients with cirrhosis.     

Clinical features and course of Kawasaki disease in central Tunisia: a study about 14 cases collected over a period of three years (2000-2002)

OBJECTIVE: To analyze the clinical features and course of Kawasaki disease in central Tunisia. We studied retrospectively 14 cases of children with Kawasaki disease collected in tunisian center during three years (2000-2002). The study is about 11 boys and 3 girls (sex - ratio: 3.6/1) aged from 6 months to 8 years (mean age : 4 years). Twelve patients had at least 5 diagnostic criteria of the illness, the two others had an incomplete form. We noted cardiac complications in seven patients treated belatedly, beyond 10 days of progression, because of atypical clinical presentations. All patients had all a middle caliber coronary aneurysm that was complicated by a thrombus in three cases, associated with pericarditis and minimal mitral insufficiency in a case and with a cardiac rhythm disturbance (block of branch) in another case. Besides the cardiac complications, several other visceral manifestation could be noted: joint symptoms in five cases, GI tract symptomes in three cases, neuro-meningeal in two cases and urinary trad symptomes in two other cases. Specific treatment (aspirin with antiinflammatory dose and intravenous immune globulin (IVIG)) has been instituted in all patients. The course was favorable for 12 patients with fast regression of clinical manifestation and progressive normalisation of biologic values. Two patients did not respond to the initial IVIG treatment, and had to recense received an additional course of IGIV but without clinical nor biological improvement. These two patients were treated with corticosteroids. Cardiac lesions disappeared completely in all patients even for those with thrombosis and in patients with IVIG-resistant Kawasaki disease. Only one patient had kept neurologic sequellae: aphasia, bevavioral problemes and partial epilepsy. CONCLUSIONS: Kawasaki disease is not rare in our region. Incomplete or atypical presentations are frequent and are a source of diagnostic delay. Coronary aneurysm due to the delay of treatment often regresses even in patients with IVIG-resistant Kawasaki disease.     

Fatal miliary tuberculosis following treatment with Infliximab

We report the first Tunisian case of miliary tuberculosis in a patient who received Infliximab for Crohn's disease with uretrorectal and ano-perineal fistula developed 4 weeks after the start of treatment. We suggest that diagnosis of latent tuberculosis infection is important before treatment with Infliximab is initiated and that antituberculous medication must be prescribed immediately in case of occurrence of unexplained fever after treatment with Infliximab.     

Exploring the effect of aspirin on primary hemostasis through bleeding time. Study of 16 volunteers

Strong anti-binding platelets, aspirin is used in the treatment or the prevention of many thrombotic pathologies. We wanted to study the effect of aspirin over the bleeding time of a group of volunteers. It consisted of 16 volunteers aged from 20 to 25 years and having no haemorrhagic or thrombotic antecedent. For each of them, we have carried out a blood count by means of an automaton Sysmex K800, followed by a measure of the bleeding time (BT). Immediately after, each volunteer has ingested 250 mg of Aspegic; then, the BT has been measured every 24 hours and up to the fifth day. The BT has been carried out by means of IVY technique 3 points, that besides the time, allows to measure the volume of bleeding (microliter). All the check-ups were normal, however, the time and volumes of bleeding were respective by short and weak. After having taken aspirin, the bleeding time has significantly become longer to day 1 and day 2 (respectively 48% and 31.5% with regard to day 0) and the volume has increased to day 1, day 2 and day 3 (respectively 122.6%, 74.7% and 38.1% with regard to day 0).     

Male gonococcal urethritis in the region of Sfax (1996-2000)

The sexually transmitted infections pose a real public health problem, mainly in developing countries. In Tunisia, the epidemiological state is not precise. The objective of our study was to determine the sociological, epidemiological and bacteriological characteristics of gonococcal urethritis in the area of Sfax. The study was performed on all patients attending at the CNSS of Sfax for urethritis for 5 years, from 1996 to 2000. A urethral swab was carried out for each patient with a classic bacteriological exam. 256 cases were collected. The mean age was 29.7 years. 74.3% were workers. The direct exam was positive in 51.2% of cases and the culture enabled us to isolate 72 strains, of which 15.5% were productive of beta-lactamase and 23.9% were resistant to tetracyclin. There was no resistance to pristinamycin, ofloxacin nor spectinomycin.